Africa: Rwanda Cited As Example of Health Financing

The importance of health as prerequisite for sustainable development was highlighted at a high-level Ministerial conference on health financing themed ‘Value for money, sustainability and accountability in the health sector’ which took place in Tunisia, from July 4 to 5.

The meeting, which was organized by member agencies of the Harmonization for Health in Africa mechanism (HHA), was attended by more than 300 participants comprising Ministers of Health, Ministers of Finance, parliamentarians, civil society organizations, private sector enterprises and representatives of bilateral and multilateral development partners.

“Rwanda was really not picking up any new ideas but rather being used as a best case,” explained Andrew Makaka, the director of health financing at the ministry of health. “When it comes to accountability we are well placed and value for money is one thing that all sectors in Rwanda use as a driving engine, more so in the health sector.”

The Director-General of the World Health Organization, Dr. Margaret Chan pointed out that as external funds directed to the development of the health sector are declining, commitment of domestic funds for health and their wise use are very critical at the moment.

Chan reminded the participants at the conference that failing to properly fund the health sector leads to an impoverished health system and does nothing to tackle the crippling shortage of health care workers that affect Africa most acutely. She added that it “impedes economic progress, puts a brake on development and keeps poor people as well as poor nations trapped in a cycle of poverty.”

“Although the African continent has made some progress, including improvement of some health indicators, this progress needs to be sustained,” said Dr. Donald Kaberuka, the President of the African Development Bank (AfDB. He called on delegates to seriously think about value for money and address inefficiencies in the health sector and how to sustain high impact interventions that can no longer be financed by development aid.

Only six countries on the African continent have allocated 15% or more of their national budget to health. Rwanda is among those six, having allocated 16% of the national budget for 2012/2013

Makaka pointed out that achieving set goals like MDGs, access to health for all and improving geographical accessibility to healthcare are some aspects of what getting the value for one’s money looks like. He acknowledged that one of the challenges they face is money managed by funding agencies. “One way to overcome this is to increase direct budgetary support from these agencies,” he remarked.

It was pointed out that more than a decade after the adoption of the Abuja Declaration in April 2001, in which heads of state of African Union countries pledged to set a target of allocating at least 15% of their annual budget to improve the health sector, only six countries on the African continent have allocated 15% or more of their national budget to health. Rwanda is among those six, having allocated 16% of the national budget for 2012/2013 to the health sector according the health ministry. In early 2011, the country was one of two countries, along with South Africa, to have achieved that target according a report by the World Health Organization.

Also highlighted is the fact that eleven countries on the continent are investing a mere US$ 5 or less per person per year in health which is far less than the amount of money needed to care for those in need of health.

Kaberuka declared that focus needs to be put on equity issues and access to coverage as health services expand. “It doesn’t have to be about spending more but rather spending more equitably,” said Kaberuka. “We cannot afford to make our systems inequitable because lack of inclusiveness, equity and access results in frustration and lack of sustainability.”